Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2014
Randomized Controlled TrialA randomized trial of the effectiveness of topical "ABH Gel" (Ativan(®), Benadryl(®), Haldol(®)) vs. placebo in cancer patients with nausea.
The topical gel known as "ABH gel," comprising lorazepam (Ativan(®)), diphenhydramine (Benadryl(®)), and haloperidol (Haldol(®)), is frequently used to treat nausea because of its perceived efficacy, relatively low cost, and ease of use in the home setting. There are limited scientific data on this medication, however. Recent pilot studies showed no absorption of the active ingredients of the gel, prompting further prospective studies into the cause of the perceived efficacy in the clinical setting. ⋯ ABH gel in its current formulation should not be used in cancer patients experiencing nausea.
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J Pain Symptom Manage · Nov 2014
Multicenter StudyLongitudinal temporal and probabilistic prediction of survival in a cohort of patients with advanced cancer.
Survival prognostication is important during the end of life. The accuracy of clinician prediction of survival (CPS) over time has not been well characterized. ⋯ Probabilistic CPS was consistently more accurate than temporal CPS over the last 14 days of life; however, its accuracy decreased as patients approached death. Our findings suggest that better tools to predict impending death are necessary.
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J Pain Symptom Manage · Nov 2014
Perceived discrimination in health care is associated with a greater burden of pain in sickle cell disease.
Perceived discriminatory experiences in society have been associated with a higher burden of pain among some minority patient populations. ⋯ Perceived disease-based, but not race-based, discrimination was found to be associated with a greater range of self-reported pain among patients with SCD. If causal, this finding could signal an important new approach to mitigating the burden of pain experienced by persons with SCD.
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J Pain Symptom Manage · Nov 2014
Multicenter StudyDoes the working environment influence health care professionals' values, meaning in life and religiousness? Palliative care units compared with maternity wards.
Increased altruism, self-transcendence, and quests for meaning in life (MiL) have been found in palliative care (PC) patients and their families who experience the finiteness of life. Similar changes were observed in healthy subjects who were experimentally confronted with their mortality. ⋯ Basic differences in values, MiL, and religiousness between PC-HCPs and MW-HCPs might have influenced the choice of working environment because no effect of job duration was observed. Longitudinal research is needed to confirm this hypothesis.
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J Pain Symptom Manage · Nov 2014
Trajectories of the multidimensional dying experience for terminally ill cancer patients.
Studies exploring the trajectories of physical-psychological-social-spiritual dying experiences frequently treat changes in these experiences as consistent across different domains and over time. ⋯ All dimensions deteriorated in the last year of life but with distinctive physical-psychological-social-spiritual/existential and overall QOL trajectories. Recognizing trajectory patterns and tipping points of accelerating deterioration in each dimension can help clinicians anticipate times of increased distress, initiate timely, effective interventions to relieve patient suffering, and facilitate high-quality end-of-life care tailored to patients' needs and preferences.